Drilling tool guide wire alignment device

ABSTRACT

A device for installation of a guide wire for a drilling tool in a correct positional arrangement in a bone. The device includes a tissue protection sleeve, which has at one end a laterally projecting grip or handle. A trocar is provided, which trocar can be introduced into the tissue protection sleeve from the handle end and whose other end is closed. The trocar is rotatable in the tissue protection sleeve and has a central bore hole and a plurality of eccentric axially parallel bore holes, through which a guide wire can be passed. A second handle is provided which extends approximately in the same direction of the first handle and whose one end engages the end of the trocar situated the outside of the tissue protection sleeve, so that the normally freely rotatable trocar is fixed in the direction of rotation relative to the tissue protection sleeve, when both handles are manually clamped against each other.

BACKGROUND OF THE INVENTION

The invention relates to an instrument for the correct positionalinstallation of a guide wire for a drilling tool in a bone.

Initial installation of a guide wire into the point of insertion iswell-known for the opening of the point of insertion of a femoral nail,for example, for proximal installation. Then the bone is opened using adrilling tool threaded over the wire. An advantage of this methodresides in the fact that prior to the actual drilling using a relativelylarge diameter, the precise position and orientation of the guide wireand, accordingly, also the subsequent bore hole can be checked with theaid of an X-ray device.

It is also well-known to initially pass a tissue protective sleeve overthe guide wire, until it is in contact with the bone, in order to avoidsoft tissue injury caused by the drilling tool. It is furtherwell-known, to close the tissue protection sleeve using a trocar, inorder to improve passage through the soft tissues. Subsequently, priorto the drilling operation, the trocar is removed.

U.S. Pat. No. 5,951,561 discloses a trocar having a plurality of axiallyparallel bores. The trocar is rotationally engaged in the tissueprotection sleeve. If, at the time of X-ray inspection, it is found, forexample, that the central bore is situated offset laterally to thedesired position in the trocar, a second guide wire is installed inanother suitable bore hole. If the second wire is positioned at thedesired location, the first wire is removed and drilling is operatedover the second wire.

SUMMARY OF THE INVENTION

One aspect of the invention is to provide a device for installing aguide wire for a drilling tool in correct positional arrangement in abone, whereby ease of manipulation and precision for placing the guidewire are improved.

In the present invention, a device having a first handle and trocarwhich can be introduced into a tissue protection sleeve are provided. Asecond handle is provided, which extends approximately in the samedirection as the first handle or grip and whose end engages the trocarexternal to the protective sleeve, so that the trocar, which is normallyfreely rotatable relative to the protective sleeve, is fixed in thedirection of rotation, when both handles are manually tensioned inopposition to each other.

The two handles are arranged in such a way that they can be grippedtogether with one hand. The connection with the trocar is such that uponclamping the two handles together the trocar is fixed in its rotationalposition. This may be accomplished by having the trocar handle deflectinto engagement with the sleeve handle. The trocar handle may be made ofan elastic material such as plastic.

Different design possibilities for affixing the trocar are conceivable.One of these according to one embodiment of the invention is achieved inthat the trocar has an annular recess, into which an annular engagementsegment of the second handle engages so that the annular engagementsegment cants into the recess and clamps the trocar, when the grips aretensioned in opposition to each other. In a surgical procedure, thesecond guide wire can be introduced into another bore hole, which moreclosely approximates the desired position, if necessary. By virtue ofthe clamping fixation of the trocar in the direction of rotation, thesecond guide wire is prevented from assuming an incorrect orientationand not attaining the desired position due to a slight relative rotationof the trocar together with the first guide wire.

Before the surgical procedure, the desired rotational position of thetrocar is adjusted. To do this, according to one embodiment of theinvention, the section of the trocar, at the end facing away from theprotective sleeve, has a rotary knob.

The second handle is preferably made of an elastic material so that itcan be deflected towards the first handle, when both handles are clampedtowards each other. Preferably, the second grip is arranged above thefirst handle.

In order to achieve the greatest possible spatial economy, oneembodiment of the invention provides that the second handle has alongitudinal slot and a deflection, bend or offset towards the firsthandle, so that a segment of the first handle engages in thelongitudinal slot. Obviously, the first handle can have a section, whichcan be deflected towards the second handle and engages approximatelyfittingly in the slot.

According to a further embodiment of the invention, the shaft of thetrocar has a shaft with a plurality of radial flanges or bands separatedlongitudinally, whose external diameters are somewhat smaller than theinternal diameter of the tissue protection sleeve and one part of theaxial bore holes in the flanges continues between the flanges as axiallyparallel grooves. In this embodiment, it is not necessary that thetrocar have a uniform thickness over its entire length with a pluralityof bore holes. The latter are situated only in the flanges, whereasaxially parallel grooves or guide channels are formed on the outersurface of the trocar shaft between the flanges. This applies at leastto a part of the plurality of bore holes.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be better understood on reading the followingdetailed description of non-limiting embodiments thereof, and onexamining the accompanying drawings, in which:

FIG. 1 is a perspective view of the device according to the invention inits disassembled condition;

FIG. 2 is a perspective view of the device of FIG. 1 in its assembledcondition; and

FIG. 3 is an end view of the trocar of the device according to FIGS. 1and 2.

DETAILED DESCRIPTION

The device represented in FIGS. 1 and 2 has a tubular tissue protectionsleeve generally denoted as 10 having a distal end, which is configuredas a relatively sharp irregular edge 12 and an enlarged proximal end 14,at which a radially projecting handle or grip 16 is located. The handlehas a rod-like form at a first section 18 with first section 18 mountedon the enlarged end 14. A section 20 of handle 16 is deflected or bentdiagonally upwards and a third section 22 is oriented approximately inthe same direction as section 18. In the preferred embodiment, sections18 to 22 are approximately circular in cross-section. A handle section24 preferably made of plastic, for example, is coupled to section 22,whereby sections 18 to 22 can preferably be made of a metal. Handlesection 24 can be pushed onto section 22.

FIG. 1 further shows a trocar generally denoted as 30, which has astopper-shaped distal end 32 having a rounded tip 34 and a shaftextending distally from end 32. In addition, on the shaft and in axialseparation two radial flanges 36, 38 are provided. In the preferredembodiment, the shaft has a smaller diameter between flanges 36, 38and/or between the flange 36 and the stopper section 32. The externaldiameter of flanges 36, 38 and of section 32 is such, that it isslightly smaller than the inner diameter of tubular tissue protectionsleeve 10. On the proximal end, the shaft has a terminal section 40,which also has the external diameter of the flanges 36, 38. A flange 42having a larger diameter connects with the section 40 and a rotary knob44 is formed at the end of the shaft. An annular recess 46 is formedbetween the rotary knob 44 and the flange 42. An annular section 48 of asecond handle 50 is seated in the annular recess 46. The annular section48 of handle 50 is slightly axially moveable and tiltable in the annularrecess 46.

The second handle 50 has a flat first section 52, which projectsapproximately radially, and in the preferred embodiment, generallyperpendicular to the longitudinal axis of the trocar shaft. In addition,handle 50 has a deflected or bent section 54 and a section 56 extendingapproximately radially forming the free end of the handle. Alongitudinal slot 58 of uniform width is formed in sections 52 and 54.

At the time of assembly, the shaft of the trocar 30 is introduced intothe tissue protection sleeve 10, whereby the flange 46 lies against theproximal facial edge of the end of the tissue protection sleeve 10.Handles 16 and 50 are arranged above one another and upon insertion ofthe trocar within the tubular sleeve 10 the deflected grip section 20 ofhandle 18 engages almost fittingly in the longitudinal slot 58 of thesecond handle 50. When this is done, the rotational position of thehandles 16, 50 is fixed relative to each other or in front of the grip50 and the tissue protection sleeve 10.

As can be seen especially in FIG. 3, the shaft of trocar 30 has fiveaxially parallel bore holes 60, which extend from the proximal end tothe end section 32 of trocar 30 and are intended to receive a guide wire(not shown) for drilling bone. As can be seen in FIG. 1, in the solidpart of the shaft of trocar 30 a central bore 61 is provided, whilst theother bores between the flanges 36, 38 and the stopper-shaped end 32 areconfigured as axially parallel grooves, as shown at 62 in FIG. 1. Ofcourse, grooves 62 could be formed as bores within a solid part of thetrocar shaft.

The rotational position of the trocar 30 within the tissue protectionsleeve 10 can be adjusted by the surgeon by rotating the knob 44. Bygripping both handles 16, 50 manually, the rotational position of trocar30 can be fixed, in that the annular section 48 cants into the annularrecess 46 and consequently securely clamps trocar 30. As can be seen,handle 50 is shorter than handle 16. In this fashion, holding tissueprotection sleeve 10 is possible without actuating or grasping handle50.

If during the surgical procedure it is found that the guide wireintroduced into the central bore hole 61, upon X-ray inspection, has notachieved the desired position, a second guide wire is introduced intoone of the bore holes 60 after turning the trocar 30. If the secondguide wire has assumed the correct position, the first guide wire isremoved. After complete introduction of the guide wire, the trocar isremoved from the tissue protection sleeve 10 and, with the aid of adrilling tool threaded onto the guide wire, the bone can be drilled.Note, as shown in FIG. 3, the bore holes 60 can be non-symmetricallyoriented around central bore hole 61 to allow more positionalorientations.

Although the invention herein has been described with reference toparticular embodiments, it is to be understood that these embodimentsare merely illustrative of the principles and applications of thepresent invention. It is therefore to be understood that numerousmodifications may be made to the illustrative embodiments and that otherarrangements may be devised without departing from the spirit and scopeof the present invention as defined by the appended claims.

1. A device for installation of a guide wire for a drilling tool in acorrect positional arrangement in a bone comprising: a tissue protectionsleeve having a longitudinal axis, which has at one end a handleprojecting laterally with respect to the sleeve longitudinal axis and atrocar having a longitudinal axis, said trocar for introduction into thetissue protection sleeve from the handle end for rotatable movementwithin said sleeve, whereby the trocar is rotatable in the tissueprotection sleeve and has a central bore hole and a plurality of axiallyparallel bore holes surrounding said central bore, through which holes,a guide wire can be passed, said trocar having a handle unconnected tothe sleeve handle extending laterally to the trocar longitudinal axiswhich can be oriented by rotation about the sleeve longitudinal axis inan approximately parallel direction to the sleeve handle, said trocarhandle having one end which engages an end of the trocar situatedoutside of the tissue protection sleeve, so that the normally freelyrotatable trocar is fixed in the direction of rotation relative to thetissue protection sleeve when both handles are manually clamped againsteach other by deflecting at least one of the handles the trocar having ashaft extending along the longitudinal axis with a knob and a flangemounted thereon on opposite sides of the trocar handle, the trocarhandle having an annular portion for rotatably receiving the shaftintermediate the knob and the flange, the annular portion of the trocarhandle is rotatable, axially moveable and tiltable with respect to thetrocar shaft longitudinal axis.
 2. The device as set forth in claim 1wherein the trocar has an annular recess in which an annular engagementsection of the second handle engages, so that the annular engagementsection cants into said annular recess and clampingly engages the trocarwhen the handles are clamped against each other.
 3. The device as setforth in claim 2 wherein a section of the trocar is configured as arotary knob at the end facing away from the tissue protection sleeve. 4.The device as set forth in claim 1 wherein a shaft of the trocar has aplurality of radial flanges arranged at axial intervals, externaldiameters of said flanges are somewhat smaller than the internaldiameter of the tissue protection sleeve and a part of the axiallyparallel bore holes continues along sections of the shaft as axiallyparallel grooves between the flanges, which shaft sections are formedhaving smaller diameters then said flanges.
 5. The device as set forthin claim 1 wherein the trocar handle is comprised of elasticallydeflectable material.
 6. The device as set forth in claim 1 wherein thetrocar handle is arranged above the sleeve handle.
 7. The device as setforth in claim 6 wherein the trocar handle has a longitudinal slot in asection facing towards the sleeve handle such that a section of thesleeve handle engages in the longitudinal slot.
 8. The device as setforth in claim 1 wherein at least two of the bore holes surrounding thecentral bore are at different radii with respect to a centrallongitudinal axis of said trocar.
 9. A device for the installation of aguide wire for a drilling tool in a correct positional arrangement in abone comprising: a tubular sleeve having a handle at a first end and aninternal bore extending along an axis; and a trocar having a bore holefor receiving the guide wire, said trocar sized for insertion into theinternal bore of said tubular sleeve and for rotation therein, saidtrocar having a handle unconnected to the sleeve handle, said handlesextending generally in parallel immediately prior to their engagement ata first end and at least one bore therethrough, said trocar handlehaving a shaft including a recess for engaging a shaft of said sleevehandle upon rotation of said trocar handle about the axis of the sleevebore into general parallel alignment with said sleeve handle the trocarhaving a shaft extending along the longitudinal axis with a knob and aflange mounted thereon on opposite sides of the trocar handle, thetrocar handle having an annular portion for rotatably receiving thetrocar shaft intermediate the knob and the flange, the annular portionof the trocar handle is rotatable, axially moveable and tiltable withrespect to a longitudinal axis of the trocar shaft.
 10. The device asset forth in claim 9 wherein said trocar handle is deflectable formoving said slot into engagement with said cylindrical portion of saidsleeve handle.
 11. The device as set forth in claim 10 wherein saidtrocar handle at said first trocar end is spaced along a longitudinalaxis of said trocar and said sleeve after assembly, beyond said sleevehandle at said first sleeve end.
 12. The device as set forth in claim 11wherein said trocar handle is made of an elastically deformablematerial.
 13. The device as set forth in claim 12 wherein the trocarhandle is made of plastic.
 14. The device as set forth in claim 9wherein said trocar has a central bore and a plurality of parallel boresaround said central bore, at least two of said plurality of bores are ata different radii with respect to a central longitudinal axis of saidcentral bore.
 15. The device as set forth in claim 14 wherein a shaft ofthe trocar has a plurality of radial flanges arranged at axialintervals, external diameters of said flanges are somewhat smaller thanthe internal diameter of the tissue protection sleeve and a part of theparallel bore holes continues along sections of the shaft as axiallyparallel grooves between the flanges, which shaft sections are formedhaving smaller diameters than said flanges.
 16. A device for theinstallation of a guide wire for a drilling tool in a correct positionalarrangement in a bone comprising: a trocar having a shaft with aplurality of bores therethrough and a handle portion at a first endthereof; and a sleeve having a bore extending along an axis forrotatably receiving said trocar shaft, said sleeve having a handleportion mounted at a first end thereof unconnected to the trocar handle,said trocar handle rotatable about the sleeve bore axis and having arecess for receiving a part of said sleeve handle portion when saidtrocar shaft is received within said bore of said sleeve wherein saidsleeve handle has a cylindrical shaft portion and said trocar handleshaft is bent and said recess in said trocar handle is a slot with saidslot moveable into engagement with said cylindrical shaft portion, thesleeve and trocar handles extending generally in parallel immediatelyprior to the engagement of the slot and shaft the trocar having a shaftextending along the longitudinal axis with a knob and a flange mountedthereon on opposite sides of the trocar handle, the trocar handle havingan annular portion for rotatably receiving the trocar shaft intermediatethe knob and the flange, the annular portion of the trocar handle isrotatable, axially moveable and tiltable with respect to a longitudinalaxis of the trocar shaft.
 17. A device for the installation of a guidewire for a drilling tool in a correct positional arrangement in a bonecomprising: a tubular sleeve having a longitudinal axis and a handleextending transversely to the longitudinal sleeve axis at a first endand an internal bore; and a trocar having a longitudinal axis and a borehole for receiving the guide wire, said trocar sized for insertion intothe internal bore of said tubular sleeve and for rotation therein, saidtrocar having a handle unconnected to the sleeve handle extendingtransverse to said trocar longitudinal axis at a first end and at leastone bore therethrough, said trocar handle having a shaft including arecess for engaging a deflectable shaft of said sleeve handle uponrotation of said trocar handle with respect to the sleeve longitudinalaxis into alignment with said sleeve handle the trocar having a shaftextending along the longitudinal axis with a knob and a flange mountedthereon on opposite sides of the trocar handle, the trocar handle havingan annular portion for rotatably receiving the trocar shaft intermediatethe knob and the flange, the annular portion of the trocar handle isrotatable, axially moveable and tiltable with respect to the trocarshaft longitudinal axis.
 18. The device as set forth in claim 17 whereinsaid deflectable sleeve handle has a cylindrical shaft portion and saidtrocar handle shaft is bent and said recess in said trocar handle is aslot with said slot moveable into engagement with said cylindrical shaftportion.